J Assoc Physicians India. 2026 Jul;74(7):42-48. doi: 10.59556/japi.74.1605.
ABSTRACT
INTRODUCTION: Diabetic retinopathy (DR) represents a frequent microvascular consequence of type 2 diabetes mellitus (T2DM). Both inflammatory activity and nutritional status influence its development. The hemoglobin-albumin-lymphocyte-platelet (HALP) index is a composite marker that reflects these factors and has been explored in several diseases. This study assessed its association with the occurrence and severity of DR.
MATERIALS AND METHODS: We carried out a cross-sectional analysis of 150 individuals with T2DM (equal male-female distribution, mean age 58.9 ± 10.9 years). Retinal changes were graded through fundus examination. Laboratory values for calculating the HALP index were obtained. Statistical analysis included t-tests, Mann-Whitney U tests, and receiver operating characteristic (ROC) curves.
RESULTS: DR was found in 43.4% of patients, predominantly in the moderate stage. The mean HALP index was 34.3 ± 36.6. Differences in HALP values between the DR and non-DR groups were not statistically significant (p = 0.249), although lower scores tended to appear in DR. ROC analysis showed modest discriminatory power (AUC 0.555 for DR; 0.599 for moderate-severe DR). Hemoglobin was significantly higher among those with moderate-severe DR (p = 0.006).
CONCLUSION: Although the HALP index did not independently predict DR, its downward trend in advanced stages suggests potential as part of a multifactorial risk assessment. Owing to its affordability and simplicity, the HALP index may complement existing tools for identifying patients at higher risk of vision-threatening DR.
PMID:42543991 | DOI:10.59556/japi.74.1605